NEXT ON "CYCLE OF HEALTH..." Dr.

RICH AND COMPANY DISCUSS FACING A TERMINAL DIAGNOSIS AND HOW KNOWING YOUR OPTIONS CAN HELP YOU TO MAKE INFORMED CHOICES ABOUT YOUR QUALITY OF LIFE THEN WE SPEAK WITH JIM BRULÉ, AN END OF LIFE DOULA WHO EXPLAINS HIS ROLE IN END OF LIFE CARE.

>> MAYBE WE WILL DIE BEFORE THIS IS OVER.

>> YOU NEVER KNOW.

>> AND ON THE NEXT MEDICAL SCHOOL MINUTE, AMELIA BOYD TALKS ABOUT THE POTENTIAL DANGER OF HERBAL SUPPLEMENTS.

THAT IS COMING UP ON "CYCLE OF HEALTH."

THIS IS PROGRAM IS BROUGHT TO YOU BY THE MEMBERS OF WCNY.

THANK YOU.

CANCER, IT'S NOT JUST A DIAGNOSIS.

IT'S A COMPLEX OPPONENT, ONE THAT CAN ALTER THE COURSE OF YOUR LIFE.

EVERY MOVE, EVERY DECISION HOLDS TREMENDOUS WEIGHT.

ST.

JOSEPH'S HEALTH HAS PARTNERED WITH ROSWELL PARK, THE REGION'S ONLY DESIGNATED CANCER CENTER TO OFFER YOU ACCESS TO PERSONALIZED THERAPIES AND LEADING ONCOLOGISTS RIGHT IN OUR COMMUNITY, AMONG THE MANY MOVES YOU CAN MAKE, THIS ONE HOLE THE POWER TO CHANGE YOUR LIFE FOR THE BETTER.

♪ ♪ ♪ ♪ >> HELLO AND WELCOME TO SIBLING PSYCH.

I'M YOUR HOST Dr.

RICH O'NEILL.

WHEN WE WERE PREPPING FOR THIS SHOW, WE DECIDED TO CHANGE THE TITLE FROM TERMINAL DISEASE TO LIVING WELL WITH TERMINAL DISEASE.

AND THEN I UNILATERALLY CHANGED IT AGAIN.

SURPRISE, PANEL.

TO LIVING WELL WITH A TERMINAL DIAGNOSIS.

JOINING US TODAY TO TALK ABOUT ALL THIS ARE MY FRIENDS LYNN SEAGREN BASS.

FORMER SCHOOL PSYCHOLOGIST WHO RETIRED AFTER LAUNCHING A CHARTER SCHOOL.

AND JUST SO HAPPENS TO HAVE A MORE SPECIFIC TERMINAL DIAGNOSIS THAN ME OR PERHAPS YOU, DEAR VIEWERS.

ALSO Ms.

ERINN MCDOWELL.

OUR TOKEN SPRING CHICKEN AND MANAGER FOR CLINICAL TRIALS AT THE CENTER CENTER AND Dr.

GREGORY EAST EASTWOOD WHO WROTE A PRETTY GOOD BOOK "PREPARING FOR THE END OF LIFE" WHAT DO YOU THINK OF MY CHANGE OF THE TITLE?

>> WELL, I THINK YOU DID A GOOD JOB TO CHANGE THE TITLE.

>> THANK YOU.

WE CAN STOP RIGHT THERE.

>> SHALL I CONTINUE?

>> YOU SHALL CONTINUE.

>> GOOD JOB ON THE CHANGE BECAUSE IT FEELS LIKE SAYING TERMINAL DIAGNOSIS-- A TERMINAL DIAGNOSIS FEELS SOMEHOW MORE GENTLE THAN SAYING TERMINAL DISEASE.

AND WHEN FIRST DIAGNOSED WITH CANCER, IT FELT LIKE JUST THE NAME ALONE WAS ENOUGH TO STRIKE FEAR IN THE HEART, YOU KNOW.

>> HOW LONG AGO WAS IT YOU WERE DIAGNOSED?

YOU WERE ON THE SHOW A NUMBER OF YEARS AGO WITH GREG.

>> IT WAS EIGHT YEARS AGO THAT I WAS DIAGNOSED.

>> EIGHT YEARS AGO, WOW.

AND IN THE BEGINNING, IT FELT LIKE JUST HEARING YOU HAD A DISEASE, AND THE DISEASE WAS CANCER, THAT, THE ASSOCIATIONS THAT WERE EXTREMELY NEGATIVE.

>> KABOOM.

>> KABOOM IS RIGHT.

>> THE BIG C,.

>> YES, YES.

BUT IN THESE YEARS, IT FEELS LIKE THE WONDER OF IT ALL IS REALIZING THAT THERE IS REASON TO HAVE HOPE AND THERE ARE LOTS OF WAYS YOU CAN COPE WITH RECEIVING THIS WORD THAT YOU HAVE THIS THING.

AND THERE IS A LOT TO DO WITH IT AND IT'S NOT REALLY-- IT'S BEEN AN INFORMATIVE RIDE, IT'S BEEN AN IMPORTANT RIDE FOR ME.

>> GREAT.

GREG, YOU AND I ARE ALSO APPROACHING THE END WITHOUT CURRENT SPECIFIC DIAGNOSES, BUT HOW DO YOU THINK AND DEAL WITH YOUR OWN IMPENDING... >> I THINK THE VIEWERS, WHICH TEND TO SENSE THAT I'M PAST THE MID POINT..., MAYBE THE HAIR COLOR, I DON'T KNOW WHAT IT IS... AND, OF COURSE, I GAVE A LOT OF THOUGHT TO THE TOPIC OF END OF LIFE WHEN I WAS WRITING THAT BOOK.

FINISHING OUR STORY.

WE ALL HAVE A STORY.

BUT PREPARING FOR THE END OF LIFE, WHAT DO WE DO.

AND I'M CERTAINLY AWARE-- YOU KNOW, LIFE IS A TERMINAL DIAGNOSIS ANYWAY, RIGHT?

FROM THE MOMENT OF CONCEPTION, THINGS BEGIN TO ACCUMULATE.

>> SLOW DOWN.

>> SO I DON'T KNOW IF I HAVE ANY WISDOM ABOUT THIS.

I HAPPEN TO LIVE IN A RETIREMENT COMMUNITY NOW, MY WIFE AND I, WHERE THERE IS A LOT OF VITAL PEOPLE.

SMART PEOPLE.

A LOT OF SOCIAL INTERACTION.

BUT YOU KNOW LINDA AND I, NOT THIS LYNN, BUT WE HAVE BEEN AWAY FOR PAST FOUR MONTHS, AND WE HAVE GOTTEN NOTICES ABOUT SEVEN OR EIGHT OF THE PEOPLE THERE HAVE PASSED AWAY.

>> O'WOW.

IT'S A PART OF LIFE TO LIVE A VIGOROUS END OF LIFE PERIOD, BUT ALSO AC ACKNOWLEDGE THAT DEATH IS A REALITY.

>> NOW, ERINN, YOU WORK IN THE UPSTATE CANCER CENTER, WHERE PEOPLE HAVE TERMINAL DIAGNOSES OFTEN TIMES.

>> CERTAINLY.

>> TELL US ABOUT YOUR WORK.

>> I WOULD LOVE TO.

SO MY TEAM AND I HAVE THE JUST PHENOMENAL, PHENOMENAL POSITION OF HELPING OUR PATIENTS THAT COME INTO THE CANCER CENTER WITH A CANCER DIAGNOSIS OF UNDERSTANDING IF THERE IS A DIFFERENT TREATMENT OPTION OUT THERE FOR THEM THAT MAY NOT BE CURRENTLY FDA APPROVED OR NEEDS MORE RESEARCH BEFORE IT'S ACCEPTED BY THE BROADER COMMUNITY.

>> SO LET ME JUST UNDERSTAND THAT.

SO THESE ARE PEOPLE WHO HAVE, MAYBE ALREADY IN TREATMENT?

>> THEY COULD BE, YES.

THEY COULD HAVE HAD, YOU KNOW, THE STANDARD THERAPY FOR THEIR CANCER AND NOW THERE IS NOTHING ELSE THAT PERHAPS INSURANCE WOULD APPROVE, BUT WE ARE STUDYING A NEW DRUG BEFORE IT HITS THE MARKET.

>> AND THAT, HENCE THE CLINICAL TRIAL.

>> IT IS IMPORTANT TO NOTE THAT A CLINICAL TRIAL IS NOT NECESSARILY HERE IS A CURE.

HERE IS AN EXTENSION OF YOUR LIFE.

BUT IT IS THE HOPE AND IT IS THE EMPOWERMENT THAT WE LIKE TO GIVE PEOPLE THAT PERHAPS THERE IS ANOTHER OPTION THAT WE CAN TRY TO GIVE YOU ANOTHER WAY OF, YOU KNOW, GIVING YOURSELF SOME MORE TIME TO DEAL WITH YOUR ILLNESS AND TO SEE IF WE CAN TURN THE CORNER FOR YOU IN A WAY THAT IS NOT ACCESSIBLE IF YOU ARE NOT ON A CLINICAL TRIAL.

>> SO, YOU SAID SOME INTERESTING THINGS, WHICH I WOULD LIKE TO COMMENT ON.

>> GO FOR IT.

>> I THINK WE ACKNOWLEDGE THAT CLINICAL TRIALS ARE RIGOROUS.

IT'S SORT OF THE APPLICATION OF I WOULD CALL HARD SCIENCE TO THE PRACTICE OF MEDICINE.

A LOT OF DATA ARE COLLECTED.

THEY'RE SCRUTINIZING VIGOROUSLY, VERY VIGOROUS STATISTICAL METHODS BUT I HEARD YOU SAY HOPE.

HOPE IS NOT A STATISTICAL TERM, RIGHT?

>> YES.

AND THAT IS ONE OF THE FAVORITE PARTS ABOUT WHAT WE DO.

YOU KNOW, I HAVE THIS PHRASE THAT I USE A LOT WHICH IS WE ARE HUMANS DOING HUMAN RESEARCH ON HUMANS.

SO WE BRING THAT ELEMENT IN, YOU KNOW, BEING A PATIENT, I MYSELF DO NOT HAVE CANCER BUT I HAVE BEEN A PATIENT IN A VIRTUAL REALITY SERIOUS SITUATION.

AND SOMETIMES THERE CAN BE A DISCONNECT BETWEEN YOU AND THE MEDICAL TEAM.

SO WE BRING THAT HUMAN ELEMENT IN TO AGAIN EMPOWER AND PERHAPS PROVIDE SOME HOPE, EVEN IF YOUR DIAGNOSIS IS NOT TRENDING A DIRECTION THAT CAN BE TURNED AROUND.

IT'S ONE OF THE BEST THINGS WE DO.

>> AND IT FEELS LIKE, IN THE GROUP I ACTUALLY AM PART OF A SUPPORT GROUP FOR THE PATIENTS WHO HAVE WHAT I HAVE.

I HAPPEN TO HAVE CHRONIC LIMP ACIDIC LEUKEMIA, A SLOWER GROWING FORM OF LEUKEMIA BUT THERE ARE SEVERAL PEOPLE IN THE SUPPORT GROUP WHO HAVE BEEN PART OF ACTIVE CLINICAL TRIALS AND WE HAVE ALL BECOME REALLY AWARE OF THE FACT THAT IF IT WERE NOT FOR CLINICAL TRIALS, MY PARTICULAR DIAGNOSIS, I HAPPEN TO BE UNMUTATED WHICH HAPPENS TO BE A BAD THING.

IF THE STANDARD MEDICATION WAS CHEMOTHERAPY.

BUT THANKS TO CLINICAL TRIALS, THE FACT THAT THE TREATMENTS HAVE MULTIPLIED MANY TIMES OVER.

>> IN YOUR EIGHT YEARS.

>> JUST IN THE EIGHT YEARS-- THINGS WERE BEING APPROVED JUST AS I WAS BEING DIAGNOSED SO DIFFERENT MEDICINES HAVE BEEN ALL COME INTO BEING AVAILABLE AND DISCUSSION OF A NEW THERAPY ON THE HORIZON.

AND WE, IN THE GROUP, ARE VERY WELL AWARE THAT WERE NOT NOT FOR PEOPLE PARTICIPATING IN CLINICAL TRIALS AND WERE IT NOT FOR THE MEDICAL PROFESSION, THANK THE MEDICAL PROFESSION AND FOR THE PEOPLE WHO DO BIO MEDICAL ENGINEERING AND ALL OF THE PARTS THAT MAKE ADVANCEMENTS IN MEDICINE POSSIBLE, WE WOULD BE STUCK WITH A SHORT LIFESPAN.

>> ABSOLUTELY.

>> AND MOST OF THE PEOPLE IN MY GROUP ARE IN TREATMENT ACTIVELY.

NOW I'M ON THE KIND OF WATCHING AND WAITING.

BUT I WILL EXPECT THAT I WILL NEED TREATMENT AT SOME POINT.

AND I'M LUCKY THAT YOU GUYS HAVE DONE WHAT YOU HAVE DONE TO EXPAND THE OPTIONS BECAUSE OTHERWISE I WAS NOT SOMEBODY WHO WOULD HAVE BEEN ABLE TO GET A CHEMOTHERAPY.

THAT DOESN'T WORK FOR UNMUTATED PEOPLE.

>> ABSOLUTELY.

>> IT'S A SPECIFIC EXAMPLE OF THE FACT THAT YOU OFFER HOPE AND THAT MATTERS.

>> AND THAT STORY CAN BE TOLD IN DIFFERENT WAYS TIME AND TIME AGAIN OUTSIDE OF CANCER, OUTSIDE OF ONCOLOGY, AS WELL.

SUNY UPSTATE WE ARE REALLY BLESSED THAT THERE IS SOMEONE LIKE MYSELF AND MY TEAM IN ALMOST EVERY DEPARTMENT THERE AND THAT IS THE SAME IN ANY LARGE MEDICAL CENTER THROUGHOUT THE NATION.

WE ARE PUSHING THE SCIENCE FORWARD TO GIVE FOLKS WITH A TERMINAL DIAGNOSIS AND OTHER FOLKS, OF COURSE, YOU KNOW, IT'S BEYOND TERMINAL DIAGNOSIS BUT WE ARE TRYING TO ENSURE THAT EVERY OPTION CAN BE EXPLORED IF THAT'S WHAT THEY WANT AND SOMETIMES WE EMPOWER THEM TO DECIDE, MAYBE IT'S NOT WHAT I WANT.

MAYBE I'M GOOD WHERE I AM AND THAT IS A GREAT DISCOVERY TO MAKE AS WELL.

>> SO YOU SAID PEOPLE WITHOUT A TERMINAL DIAGNOSIS, WHICH SURPRISED ME BECAUSE I ALWAYS THINK IF I GO IN A CLINICAL TRIAL, THAT MEANS I'M REALLY CLOSE TO DEATH AND THERE IS NO OTHER TREATMENT OPTION.

BUT IT SOUNDS LIKE THAT IS NOT THE CASE.

>> IT'S NOT THE CASE.

AND THAT'S A GREAT POINT BECAUSE , YOU KNOW, AS YOU WERE SAYING, I WAS GETTING A SCARY DIAGNOSIS.

SOMETIMES HEARING THE PHYSICIAN COME IN AND SAY I HAVE A CLINICAL TRIAL FOR YOU MAKES PEOPLE THINK THEY ARE IN A BAD SPOT BUT CAN WE GIVE A SUPPORTIVE MEDICATION TO HELP WITH SIDE EFFECTS.

SOME PEOPLE JOIN CLINICAL TRIALS TO GIVE BACK TO THE COMMUNITY AND THE SCIENTIFIC COMMUNITY AT LARGE.

SO CLINICAL TRIAL IS IN NO WAY ABSOLUTELY I'M IN TROUBLE HERE.

IT CAN BE.

BUT IT CAN ALSO BE, YOU KNOW, FOR A WIDE VARIETY OF INDIVIDUALS AS WELL.

>> THAT'S GREAT TO KNOW.

SO IT USED TO BE, I REMEMBER WHEN I WAS A KID, THE BIG C, CANCER, MEANT YOU WERE JUST GOING TO BE DEAD PRETTY SOON AND THINGS HAVE, SOUNDS LIKE THINGS HAVE REALLY RADICALLY CHANGED.

>> RADICALLY CHANGED.

FOR SOMEONE WHO IS FORTUNATE ENOUGH, I HAVE A SLOWER PROGRESSING FORM OF LEUKEMIA, BUT THE ADVANCEMENTS IN WHAT IS POSSIBLE HAVE REALLY MADE IT SO THAT MY DOCTOR IN MY MOST RECENT VISIT SAID IT IS HIGHLY LIKELY I WOULD BE ABLE TO LIVE A NORMAL LIFESPAN AND BENEFIT FROM THE TREEPTS THAT ARE THERE.

SO THAT LED ME TO TELL MY KIDS AND HUSBAND RIGHT AWAY AS I CAME OUT OF THE APPOINTMENT, IT WAS DELIGHTFUL AND THAT'S ALL POSSIBLE BECAUSE OF THE NEW THINGS AVAILABLE.

>> ONE OF THE THINGS THOUGH, THAT HAPPENS, I THINK, IS THAT THERE IS A LOT OF HOPE WHEN SOMEONE ENTERS A CLINICAL TRIAL, BUT THE CLINICAL TRIAL IS THERE TO DISCOVER WHETHER THIS ALTERNATE OR THE NEW TREATMENT IS BETTER OR MAYBE WORSE THAN THE STANDARD.

HOW DO YOU DEAL WITH PATIENTS AND FAMILIES AND EXPLAINING THAT ALTHOUGH THERE IS HOPE, IT'S POSSIBLE IT WON'T DO AS WELL AS STANDARD THERAPY?

>> YEAH, WE HAVE A REALLY, REALLY IMPORTANT ROLE TO PLAY THERE BECAUSE, YOU KNOW, BACK IN THE DAY, CLINICAL TRIALS GOT A BAD RAP.

YOU MAY NOT KNOW THAT YOU WERE ON A PLACEBO, THAT WERE YOU GETTING TREATMENT THAT YOU REALLY NEEDED AND THANKFULLY THOSE DAYS ARE GONE.

THE FIRST STEP OF A CLINICAL TRIAL IS INFORMED CONSENT TO REALLY EXPLAIN... >> I HAVE TO GIVE YOU INFORMED CONSENT.

WE HAVE TO GO TO THE PACKAGED VIDEO.

WE'LL FINISH YOUR THOUGHT WHEN WE COME BACK AND FOLKS, OUR "CYCLE OF HEALTH" TEAM AND I VIVED JIM BRULÉ, WE VISITED JIM BRULÉ, AN END -OF- LIFE DOULA WHO EXPLAINS THE UNIQUE ROLE HE PLAYS AT END -OF- LIFE CARE.

LET'S LOOK AT A PORTION OF THAT INTERVIEW.

>> HOW DO YOU WORK WITH PEOPLE WHO ARE CLOSER TO DEATH?

>> IT'S A LOT LIKE BEING A BIRTH DOULA, BEING A DEATH DOULA.

PEOPLE ARE TRANSITIONING FROM ONE STATE TO ANOTHER.

THEIR FAMILIES ARE.

AND MOST OF WHAT THEY'RE FACING IS FEAR AND IGNORANCE.

SO THERE IS A LOT OF EDUCATION THAT GOES ON.

WHAT DOES MY BODY GO THROUGH AS I DIE?

WHAT HAPPENS TO MY MIND?

WHAT FORMS DO I NEED TO SIGN?

HOW DO I PROTECT MYSELF, HOW DO I PROTECT MY FAMILY.

HOW DO I MANAGE MY FEARS AND MY FAMILY'S FEARSS AAS I'M GOING THROUGH THIS?

>> YOU GET THE REGULATORY LEGAL STUFF OUT OF THE WAY AND THEN YOU CAN FOCUS ON THE EMOTIONAL ASPECTS OF DYING?

>> EXCEPT THEY'RE INTERWOVEN.

SO, FOR EXAMPLE, PEOPLE WILL SAY I WANT TO HAVE SOMEONE BE MY HEALTHCARE PROXY AND THERE IS A FORM TO FILL OUT.

BUT ALL THAT DOES IS IT GIVES A PERSON THE ABILITY TO SPEAK FOR YOU.

WELL, IF THEY DON'T KNOW WHAT YOU WANT, THEY CAN'T REALLY SPEAK FOR YOU.

SO A LOT OF IT IS ELICITING FROM THEM, WHAT IS IT THAT YOU WANT AND HOW CAN WE HELP THIS PERSON UNDERSTAND WHAT YOU WANT BECAUSE IT CAN'T PREDICT EVERYTHING.

IN OUR CULTURE, GRIEF IS SOMETHING TO BE CURED.

AND IT'S NOT.

GRIEF IS A COMPANION.

AND ANYONE WHO HAS HAD ANY KIND OF MEASURABLE GRIEF-- AND THAT'S MOST OF US-- WILL DO MUCH BETTER IF THEY SAY THIS GRIEF WAS A TEACHER FOR ME AND IT'S NOW MY COMPANION.

I NOW WALK WITH IT.

WHAT CAN I LEARN FROM IT.

>> THAT'S A LOVELY WAY TO THINK ABOUT IT.

>> GRIEF IS STRONG.

IT'S A STRONG COMPANION.

AND IF WE LEARN HOW TO WALK WITH IT, OUR LIVES GET EVEN MORE WONDERFUL.

BUT WE CARRY AROUND THE PAIN OF THE LOSS, WHATEVER IT IS.

IT'S P CLL.

WHAT DOES THE END OF LIFE DOULA, WHAT HE JUST SAID, HAVE TO DO WITH YOU?

TIMES, WHEN YOU ARE FACING DEATH, YOU REALLY CAN BENEFIT FROM PEOPLE WHO ARE ABLE TO HELP YOU TALK ABOUT IT, TO COMMUNICATE ABOUT A VERY DIFFICULT THING THAT YOU FEEL, HAVE A LOT OF FEELING ABOUT.

AND I MEAN HE IS TALKING ABOUT THE END OF LIFE.

I ACTUALLY, IN OUR SUPPORT GROUP, WE HAVE PEOPLE AT ALL STAGES.

LIKE I AM EXPECTING TO LIVE A LONG TIME WITH THIS.

>> I HOPE SO.

>> I HOPE SO, TOO.

AND THERE ARE THINGS HE WOULD BE WITH A FAMILY AT THE END OF LIFE.

THERE IS HOSPICE CARE THAT ALSO ASSIST PEOPLE AT THE END OF LIFE AND PALLIATIVE CARE THAT ASSIST PEOPLE BEFORE THEN, HAVING DIFFICULT CONVERSATIONS AND REALLY HELPING PEOPLE COME TO GRIPS WITH THE REALITY.

AND THEN IN OUR SUPPORT GROUP, WE ARE SORT OF LIKE ANOTHER LAYER OF IT WHERE YOU REALLY ENCOURAGE PEOPLE TO TALK WITH EACH OTHER ABOUT THEIR FEARS AND ABOUT THEIR UNDERSTANDING OF THE DISEASE, LIKE SOME INFORMATION ABOUT IT.

BUT ABOUT THE FEELINGS.

AND HE IS TALKING ABOUT THE FEELINGS THAT ARISE WHEN YOU ARE FACING THESE TRANSITIONS.

AND THAT'S VERY IMPORTANT STUFF.

>> YOU KNOW, I MIGHT JUST COMMENT ON PALLIATIVE CARE BECAUSE I'VE HAD EXPERIENCE WITH FAMILIES AND PATIENTS IN THE HOSPITAL BEING OFFERED PALLIATIVE CARE AND SOMETIMES THE REACTION IS OH YOU ARE GOING TO STOP TREATING ME NOW?

AND PALLIATIVE CARE IS CONTEMPLATED WHEN ALL MEASURES TO CURE THE DISEASE OR AT LEAST PUT THE DISEASE IN REMISSION, HAVE FAILED, FRANKLY.

AND I THINK MANY OF OUR LISTENERS CAN RELATE TO THAT WITH FRIENDS AND RELATIVES THEY HAVE KNOWN WHO HAVE BEEN IN THE SAME SITUATION.

SO PALLIATIVE CARE IS A DIFFERENT KIND OF CARE.

IT'S CARE.

AND IT'S CARE FOR PAIN, AND YOU KNOW, YOU DO TREAT PATIENTS-- LET'S SAY SOMEONE WITH A TERMINAL DIAGNOSIS IS EXPECTED TO DIE WITHIN A MONTH OR TWO MONTHS; HAS A URINARY TRACT INFECTION.

WE USUALLY TREAT THAT BECAUSE THEY'RE VERY PAINFUL.

SO WE DO TREAT THE APPROPRIATE THINGS BUT MAKE SOME JUDGMENTS ABOUT WHETHER WE ARE CONTINUING TO TREAT, SAY WITH SURGERY OR CHEMOTHERAPY OR SOMETHING.

AND THEN HOSPICE, IN MY VIEW, IS SORT OF A SUBSIDIARY OF PALLIATIVE CARE; A FORM OF PALLIATIVE CARE.

TO BE ELIGIBLE FOR HOSPICE, YOU HAVE TO HAVE A LIFE EXPECTANCY OF SIX MONTHS OR LESS.

DOCTORS ARE NOTORIOUS FOR MISSING THE MARK.

BUT IT'S INTERESTING, THE DATA OF PEOPLE WHO USE HOSPICE, THE MEDIAN; THAT MEANS HALF THE PEOPLE DIE WITHIN THREE WEEKS OF ENTERING HOSPICE.

>> OH WOW.

>> THE OTHER HALF LONGER, BUT VERY FEW MAKE IT TO SIX MONTHS.

I THINK JAMIE CARTER WAS MAKING IT-- >> A LONG TIME.

>> ONE THING THERE.

AND HOSPICE USUALLY HAPPENS AT HOME OR WHEREVER THE PERSON IS LIVING.

BUT AGAIN HOSPICE IS CAREFUL ATTENTION TO THE NEEDS OF THE PATIENT.

>> I SEE YOU NODDING VIGOROUSLY OVER THERE.

WHILE THE DOULA WAS ON, TOO.

DO YOU HAVE SOME COMMENT ABOUT THAT?

>> YEAH, YOU WOULD THINK I'M OVER HERE THINKING CLINICAL TRIALS, ONE MORE OPTION.

IT'S SO IMPORTANT TO HAVE THIS CONVERSATION AS A WHOLE BECAUSE CLINICAL TRIALS MAY NOT BE FOR EVERYBODY, YOU KNOW, PEOPLE NEED TO BECOME INFORMED THAT END OF LIFE CARE, TERM NATIONAL ILLNESS, ET CETERA, THERE IS A DECISION TREE THAT YOU CAN MAKE THERE.

AND SOMETIMES I THINK PEOPLE DON'T REALIZE THE DECISIONS.

MY DOCTOR SAYS TO DO THIS AND THEN THIS AND I'M DONE AND I DON'T HAVE ANYTHING ELSE AND I'M SCARED BECAUSE WE HAVE NEVER TALKED ABOUT WHAT IT IS GOING TO LOOK LIKE.

SO I'M JUST SAYING YES, YES, YES, IN MY HEAD.

IT'S GREAT TO BE TALKING ABOUT THIS.

>> SO IS ONE OF THE THINGS YOU REALLY DO IS TALK, GIVE PEOPLE THE SPACE TO TALK ABOUT ALL OF THESE THINGS THAT, LIKE, IN MY FAMILY, I DON'T THINK WE EVER TALKED ABOUT DEATH.

I CAME TO VISIT MY FATHER WHETHER HE WAS ON HIS DEATH BED.

EVERYBODY KNEW HE WAS GOING TO DIE.

AND SHED TO ME-- HE SAID TO ME, ARE YOU COMING HERE TO WATCH ME DIE?

AND THAT'S THE FIRST TIME ANYBODY HAD USED THAT WORD.

AND HE WAS-- OBVIOUSLY.

IS THAT ONE OF THE THINGS YOU DO SOME YOUR OFFICE?

>> OUR TEAM IS NOT NECESSARILY TRAINED TO HAVE THE MORE SERIOUS HIGH LEVEL MEDICAL CONVERSATIONS.

WE BEGIN ARE CERTAINLY THERE TO PUT THE HUMAN ASPECT INTO IT.

WE ARE TALKING ABOUT HOW IMPORTANT INFORMED CONSENT IS.

WE ARE THERE TO KEEP AN EAR OUT TO SAY IS THIS PERSON SAYING YES BECAUSE THEIR FAMILY IS NO THE READY TO LET GO AND WANTS THEM TO TRY SOMETHING ELSE OR IS THIS PERSON SAYING YES BECAUSE THEY WOULD LIKE TO TRY ANOTHER OPTION?

AND SO WE ARE THERE TO ENSURE THAT THINGS ARE GOING WELL AND THAT THE PATIENT IS EMPOWERED TO MAKE THE DECISION THAT'S RIGHT FOR THEM AT THAT TIME IN THEIR LIFE.

>> YOU KNOW, THIS MIGHT BE A GOOD TIME TO TALK ABOUT THE QUESTION, ARE MY WISHES ABOUT END OF LIFE BEING FOLLOWED, BECAUSE VERY OFTEN... >> IS THAT SOMETHING YOU CONSULT WITH PEOPLE ON?

>> THAT'S A MAJOR REASON THAT CONSULTANTS GET CONSULTED.

IT HAS TO DO WITH THIS WHOLE BUSINESS OF ASKING SOMEONE ELSE TO BE AVAILABLE IF YOU CAN'T-- IF YOU PASS A POINT WHERE YOU CAN MAKE YOUR OWN DECISIONS, ASKING SOMEONE ELSE TO MAKE DECISIONS.

>> HEALTHCARE PROXY.

RIGHT?

>> HEALTHCARE APPROXIMATE AGREE THERE YOU GO, RICH.

>> I HAPPEN TO HAVE AN OFFICIAL NEW YORK STATE HEALTHCARE PROXY BUT YOU CAN GET THEM FROM ANY PLACE.

>> GOOGLE IT.

>> BUT THE POINT IS THAT YOU SHOULD APPOINT SOMEBODY.

MANY OF THE LISTENERS HAVE DONE THIS ALREADY, BUT MANY HAVE NOT.

YOU SHOULD APPOINT SOMEBODY WHO KNOWS YOUR WISHES, IT COULD BE A SPOUSE BUT MAYBE THE SPOUSE ISN'T RIGHT PERSON.

IT COULD BE A CHILD OR SOMEONE ELSE.

AND THEN YOU SHOULD HAVE CONVERSATIONS.

THAT'S WHAT WE ARE TALKING ABOUT, HAVE A CONVERSATION.

SOMETIMES THE HEALTHCARE PROXY DOESN'T HAVE AN IDEA OF WHAT THE PERSON WOULD WANT UNDER CERTAIN CIRCUMSTANCE.

>> AND IT IS IMPORTANT TO KNOW IF YOU ARE GOING TO HAVE TO MAKE A DECISION.

I'M GIVING YOU THE LAST WORD, 30 SECONDS, LYNN, TO SAY... >> JUST ENCOURAGE THE FACT THAT PEOPLE SHOULD TALK ABOUT THESE THINGS, AND AGAIN, THE SUPPORT GROUPS ARE A WONDERFUL WAY TO DO THAT AND THE WILLINGNESS TO SEEK PALLIATIVE CARE.

IT'S A PLACE TO HAVE CONVERSATIONS BECAUSE TALKING ABOUT THIS STUFF DEMYSTIFIES IT AND CAN HELP YOU TO FOCUS ON FINDING JOY IN THE LAST PART OF YOUR LIFE.

>> I LIKE THAT.

>> AND FINDING JOY, LOVING DEEPLY, ENJOYING NATURE, ENJOYING MUSIC.

THESE ARE THE THINGS THAT BRING US LIFE IN WHATEVER DAY WE HAPPEN TO BE ALIVE IN.

>> HOPE AND JOY.

>> YEAH.

>> THAT'S ENDING ON THAT, FOLKS, BEFORE WE WRAP OUR SHOW TODAY, IT'S TIME FOR A MEDICAL STUDENT MINUTE.

THIS WEEK Ms.

AMELIA BOYD EXPLAINS A SURPRISING DANGER AT CONVENIENT STORES AND HOW YOU MIGHT BE TAKING LIFE THREATENING DRUGS WITHOUT EVEN KNOWING IT.

LET'S TAKE A LOOK.

>> HI, I'M AMELIA BOYD FOURTH YEAR MEDICAL STUDENT WITH MY MEDICAL STUDENT MINUTE ABOUT A SURPRISING DANGER AT CONVENIENT STORES.

HERBAL SUPPLEMENTS IN FLASHY PACKAGES ADVERTISING THINGS LIKE BOOSTING ENERGY OR FOCUS, OR HELPING WITH PERFORMANCE.

THE PROBLEM IS, MANY OF THESE PRODUCTS ARE NOT LABELED AND EVEN THOSE THAT ARE MAY NOT BE WHAT THEY CLAIM.

FDA TESTING HAS REVEALED THEY OFTEN CONTAIN PRESCRIPTION DRUGS WITHOUT LABELING THEM.

THAT MEANS YOU COULD BE UNKNOWINGLY TAKING POWERFUL MEDICATIONS.

FOR SOME PEOPLE, ESPECIALLY THOSE WITH HEART PROBLEMS OR ON MEDICATIONS LIKE NITRATES THIS CAN BE EXTREMELY DANGEROUS.

THESE HIDDEN DRUGS CAN CAUSE SERIOUS SIDE EFFECTS LIKE DANGEROUSLY LOW BLOOD PRESSURE OR INTERACTIONS WITH OTHER PRESCRIPTION.

THESE ARE NOT REGULATED OR TESTED FOR SAFETY.

SO IF YOU ARE CONSIDERING ONE OF THESE PRODUCTS.

IT'S SAFER TO TALK WITH YOUR DOCTORS ABOUT YOUR CONCERNS INSTEAD.

I'M AMELIA BOYD WITH MY MEDICAL SCHOOL MINUTE.

>> THAT'S ABOUT ALL THE TIME WE HAVE.

I WANT TO THANK OUR GUESTS LYNN SEAGREN BASS.

MY FRIEND AND PATIENT LIVING WELL WITH A TERMINAL DIAGNOSIS.

ERINN MCDOWELL.

CLINICAL TRIALS MANAGER AT UPSTATE CANCER CENTER AND MY FRIEND AND COLLEAGUE Dr.

GREGORY EASTWOOD, AT UPSTATE MEDICAL UNIVERSITY.

CHECK UP FROM THE NECK UP IS AT WCNY.ORG/COMMUNITY FM AND IF WOULD YOU LIKE TO REVISIT THIS EPISODE AND PAST SEASONS, INCLUDING THE FULL LENGTH INTERVIEW WITH END -OF- LIFE DOULA JIM BRULÉ, VISIT WCNY.ORG/"CYCLE OF HEALTH" OR MY WEBSITE Dr.

NECKUP.ORG.

FOR "CYCLE OF HEALTH," I'M Dr.

NECKUP, PSYCHOLOGIST Dr.

RICH O'NEILL.

THANK YOU FOR CHECKING UP WITH US.

♪ ♪ ♪ ♪ NEXT WEEK ON "CYCLE OF HEALTH..." OUR PANEL TAKES A LOOK AT HEART DISEASE FROM HOW RISK IS DETERMINED AND THE LATEST ADVANCED IN TREATMENT TO WHAT YOU SHOULD BE DOING TO TAKE CARE OF YOUR HEART.

THEN WE JOIN THE AMERICAN HEART ASSOCIATION FOR THE ANNUAL SYRACUSE HEARTWALK.

AND ON THE NEXT MEDICAL STUDENT MINUTE, RAQUEL BATISTA EXPLAIN HOW CHILDHOOD STRESS CAN SHAPE OUR RESPONSES TO STRESS LATER IN LIFE.

THAT'S COMING UP ON "CYCLE OF HEALTH."

THIS IS PROGRAM IS BROUGHT TO YOU BY THE MEMBERS OF WCNY.

THANK YOU.

CANCER, IT'S NOT JUST A DIAGNOSIS.

IT'S A COMPLEX OPPONENT, ONE THAT CAN ALTER THE COURSE OF YOUR LIFE.

EVERY MOVE, EVERY DECISION HOLDS TREMENDOUS WEIGHT.

ST.

JOSEPH'S HEALTH HAS PARTNERED WITH ROSWELL PARK, THE REGION'S ONLY DESIGNATED CANCER CENTER TO OFFER YOU ACCESS TO PERSONALIZED THERAPIES AND LEADING ONCOLOGISTS RIGHT IN OUR COMMUNITY, AMONG THE MANY MOVES YOU CAN MAKE, THIS ONE HOLE THE POWER TO CHANGE YOUR LIFE FOR THE BETTER.